Vaser assisted high definition liposculpture

ABSTRACT

A surgical procedure for performing liposculpture on the human body comprising defining a surgical site where the liposculpture is to be performed including substantially 360 about at least the torso portion of the body and/or the limbs. The surgical site is infiltrated with a predetermined quantity of solution and subsequently performing multi-layer emulsification of fat deposits about the surgical site utilizing technology comprising “vibration amplification of sound energy at resonance” or (VASER), wherein the multi-layer emulsification includes at least a superficial layer emulsification of fat deposits and a deep layer emulsification of fat deposits. Subsequently, a multi-layer liposuction extraction of the emulsified fat deposits is performed, wherein the multi-layer liposuction extraction comprises a deep layer liposuction; a superficial layer liposuction and an intermediate layer liposuction.

CLAIM OF PRIORITY

The present application is a continuation-in-part application ofpreviously filed, application having Ser. No. 13/461,027, filed on May1, 2012, which matured into U.S. Pat. No. 8,876,799 on Nov. 4, 2014,which is a continuation-in-part application of previously filed,application having Ser. No. 12/287,816, filed on Oct. 14, 2008incorporated herein by reference, which matured into U.S. Pat. No.8,167,868 on May 1, 2012.

BACKGROUND OF THE INVENTION

Field of the Invention

The present invention is directed to a surgical procedure foraccomplishing liposculpturing of the human body which incorporates theuse of “VASER” technology or “vibration amplification of sound energy ofresonance”. Inclusive in the surgical procedure is the multi-layeremulsification of fat deposits about a surgical site associated with aportion of the body, including at least the torso of the body and/or oneor more selected limbs of the body, wherein the surgical site may extendsubstantially 360° about the selected body portion. Multi-layerliposuction is utilized to extract the emulsified fat deposits resultingin a three-dimensional technique which enhances the natural muscularityof the patient's body.

Description of the Related Art

Lipoplasty is currently the plastic surgical procedure performed mostoften in the United States, wherein the fundamental technique andtechnology associated therewith have changed only slightly during thepast 30 years. Superficial lipoplasty with standard lipoplasty cannulasexpand the boundaries of body contouring by enabling the removal of fatfrom superficial layers. However, this advance in lipoplasty techniquehas also involved increased risk of scarring and contour irregularities.

Existing publications indicate that traditional lipoplasty techniquesoften fail to achieve the aesthetic goal of a “wash board” abdominalcontour because sub-dermal fat often obscures the muscular detail. Knowntechniques referred to as “abdominal etching” use different lipoplastyto detail abdominal musculature, specifically the rectus abdominismuscle, between the linea alba and the linea semilunaris, while alsoaddressing the tendinous inscriptions of the rectus abdominis muscle.However, abdominal etching was designed specifically for the male bodyhaving between 8% and 15% body fat and was limited to only interiorabdominal wall. Accordingly, female and/or moderately obese patientswere not susceptible subjects for the known abdominal etching surgicalprocedure.

Therefore, there is a need in the area of body sculpturing for a highdefinition liposculpture surgical procedure which would represent asignificant improvement in body contouring. As such, the terms“liposculpture” is utilized to define a surgical technique which doesnot simply remove fat, but represents an “artistic approach” designed toemulate surface anatomy. Accordingly, a proposed improvement in thisarea would include “high definition liposculpture” (HDL), whichrepresents a development through the study of art and anatomy of thehuman musculature as an artistic treatment of the human form to createnot only a slim figure but also the appearance of a highly developedmusculature. Further, a proposed HDL procedure elevates the concept ofabdominal etching to a three-dimensional approach taking into accountthe contributions made by other muscle groups to integrate the entire orsubstantially 360 degrees of the torso and in certain instances thelimbs, including the legs or arms, as well as back of the body on whichthe surgical procedure is being performed. As a result, the differingaesthetic goals of male and female body contouring can be integratedinto such a proposed procedure which further includes key areas such aspectorals in men and the gluteal area in women.

Further, the proposed unique and improved surgical procedure for bodysculpturing may appropriately incorporate the use of “VASER” technologyor “Vibration Amplification of Sound Energy at Resonance” with the HDLprocedure. This association represents a marriage between technology andtechnique that allows a more precise, less traumatic procedure withimproved outcomes. Accordingly, VASER assisted HDL or “VAHDL” allows fattissue to be prepared for more effective sculpturing throughemulsification. As such, the surgeon can “sculpt” muscular anatomy ingreat detail through gentle extraction aspiration that minimizes thetrauma normally associated with traditional lipoplasty. Further, VAHDLembodies the ultimate understanding of how superficial anatomyinfluences external appearance. As such, VAHDL has been developedthrough the study of “surface anatomy” of the human musculature much asan artist would view the human form and begins where superficiallipoplasty ends. In addition, the unique surgical procedure defined byVAHDL highlights the importance of contributions made to the aestheticsof the human form by both superficial and deep fat layers when theselayers are properly proportioned both between and over the associatedmuscle groups.

SUMMARY OF THE INVENTION

The present invention is directed to a three-dimensional technique whichenhances natural muscularity of the patient and includes transitioning,comprising an intermediate layer liposuction technique to facilitate theenhancement of intended results. As such, high definition liposculptureis utilized in combination with VASER technology to define the presentinvention comprising “VASER assisted high definition liposculpture” or“VAHDL”.

The VAHDL procedure of the present invention preliminarily involves apreoperative surgical marking of a patient when in the operating roomwith the patient initially disposed in a supine position and completedwith a patient in an upright standing position. As such, anunderstanding of superficial anatomy and human typography is important,thereby requiring the surgeon to learn how to examine the patient forindividual characteristics in order to avoid inaccurate marking whichcould possibly lead to deformities and abnormal appearance. In theapplication of the VAHDL procedure, it is to be noted that the surfaceanatomy varies between men and women. In women, the transversal lines inthe rectus abdominis muscle are not aesthetically desirable because theytend to look too “masculine”. In men, the landmarks marked maypreferably include pectorals major, serratus interior, rectus abdominis,external oblique, iliac crest and inguinal ligaments as well as therelationship between these structures.

Further, the VAHDL surgical procedure of the present invention comprisesboth a superficial and deep infiltration performed using solution of1,000 cc of normal saline as well as 1 cc of epinephrine. Detailedinfiltration may be performed in areas that require more superficialworks, such as the waist and perigluteal area in women and other areasin the male body. Further, in anticipation of the use of VASERtechnology, the exact amounts of infiltration in each area and theestimated time of VASER use are determined and maintained.

The VASER technology is a primary technique for accomplishingemulsification of predetermined fat deposits. Further, theemulsification technique using VASER technology is performed preferablyin a continuous mode for the high de-bulking and in a pulsed mode atlower power for more delicate areas and the immediate sub-dermal plane.Preferably, the de-bulking was performed using ventilated cannulas,beginning in the deep layers and continuing to the mid-lamellar layerand between muscle groups. Superficial emulsification was performed todefine the relevant anatomy of the muscle groups in each treatment area.Transitioning was then performed to define the superficial anatomylandmarks. As used herein “transitioning” comprises the de-bulking orextracting of some of the remaining fat deposits existing over theassociated muscle groupings and smoothing the surfaces over theassociated anatomical areas, such as the mid-lamellar area.

Accordingly, the VAHDL surgical procedure of the present inventioncomprises a multi-layer emulsification technique comprising both deeplayer emulsification of fat deposits and superficial layeremulsification of fat deposits using VASER technology, as described ingreater detail herein. Subsequently, multi-layer liposuction is appliedto accomplish a more specific definition of the relative anatomy of themuscle groups in each anatomical section of the surgical site, as wellas the transitioning of anatomy landmarks by removing the remaining fatover predetermined muscle groups specifically, but not exclusively, inthe mid-lamellar area.

These and other objects, features and advantages of the presentinvention will become clearer when the drawings as well as the detaileddescription are taken into consideration.

BRIEF DESCRIPTION OF THE DRAWINGS

For a fuller understanding of the nature of the present invention,reference should be had to the following detailed description taken inconnection with the accompanying drawings in which:

FIG. 1 is a schematic representation in block diagram form representingrelated and cooperative surgical steps and techniques which collectivelydefine the “VASER assisted high definition liposculpture” or “VAHDL”surgical procedure of the present invention.

Like reference numerals refer to like parts throughout the several viewsof the drawings.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

The present invention is directed to a VASER assisted high definitionliposculpture surgical procedure and is a three-dimensional techniquewhich enhances the natural muscularity of the patient resulting in thecreation not only of a slim figure for the human body but also theappearance of highly developed muscularity. As such, the VASER assistedhigh definition liposculpture or “VAHDL” is applicable for use on bothmen and women with less limitations relating to body physique, age,gender, etc. than known or conventional body sculpturing techniques.Distinguishing features of the VAHDL procedure include the use ofunderlying anatomical structures as a guide to accomplishing theintended three-dimensional body contour.

Further, while the surgical site, in at least one embodiment of thepresent invention represents 360 degrees about at least the torsoportion of the human body, this three-dimensional approach can also takeinto account the contributions made by other muscle groups to integrateand further define the surgical site to include substantially the entiretorso, back and limbs including the legs and arms. The subject VAHDLsurgical procedure in the various preferred embodiments of the presentinvention utilizes the assistance of “vibration amplification of soundenergy at resonance” or “VASER” technology. In utilizing VASERtechnology, the VAHDL surgical procedure enables the application oflipoplasty techniques to the superficial fat layers or deposits andovercomes certain disadvantages associated with “abdominal etching”which has limited applicability in terms of gender and obesity ofqualified patients.

More specifically, VASER technology as applied to the subject VAHDLsurgical procedure is preferably performed utilizing a solid probe thatgenerates ultrasound on various multi-layers for purposes of emulsifyingfat deposits. As set forth in greater detail, VASER technology is usedin the performance of multi-layer emulsification of fat deposits at andsubstantially about 360° of the surgical site. Subsequently multi-layerliposuction was applied to the various anatomical sections to extractthe emulsified fat deposits thereby accomplishing the desiredsculpturing and muscularity of the patient about the 360° surgical site.

With primary reference to the schematic representation of theaccompanying FIGURE, the VAHDL surgical procedure is generally indicatedas 10 and initially comprises preoperative marking 12 of the patient. Atleast partially dependent on the selected surgical site, thepreoperative marking 12 is preferably performed with the patientinitially supine and completed with the patient in an upright standingposition. Subsequent to the preoperative marking 12, an infiltration ofthe body about the surgical site, which may include substantially 360°about the surgical site, is accomplished, as at 14. More specifically,the infiltration technique or process 14 comprises the infiltration of apredetermined quantity of saline solution, such as substantially 1,000cc, and epinephrine, in a predetermined quantity, such as generally 1cc. This solution is infiltrated about the surgical site, which mayinclude substantially 360° about the surgical site, by performing aplurality of anatomical incisions 16 through which the fluid isintroduced using infiltration cannulas 18.

Subsequent to the infiltration procedure, the additional, non-mobilestep in the VAHDL surgical procedure involves emulsification, as at 20,and more specifically multi-layer emulsification at the surgical site,which may include substantially 360° about the surgical site. As setforth above, the emulsification of fat deposits is performed using VASERtechnology as at 22 and is preferably performed by a solid probe thatgenerates ultrasound on superficial tissue layers and deep tissuelayers. In a preferred embodiment emulsification may first be preformedon superficial tissue layers and subsequently on the intermediate ordeep tissue layers. The VASER probe generates a specific frequency thatis selective to fat and accomplishes the emulsification of fat depositsin its path or as applied. Accordingly, with reference to theaccompanying FIGURE, the emulsification 20, utilizing the VASER assistedtechnology 22 involves a multi-layer emulsification comprising at leasta superficial layer emulsification of fat deposits, as at 24 and a deeplayer emulsification of fat deposits, as at 26. The utilizing the VASERassisted technology 22 the multi-layer emulsification may also comprisea superficial layer emulsification of fat deposits, a deep layeremulsification of fat deposits, and an intermediate layer emulsificationof fat deposits.

Thereafter, a multi-layer liposuction is performed for the extraction ofthe emulsified fat deposits, as at 28. The multi-layer liposuction ismore specifically defined by accomplishing a superficial layerliposuction 30, a deep layer liposuction 32 and an intermediate layerliposuction 34. It should be noted that the order or sequence ofapplying the liposuction to the superficial, deep and/or intermediatelayers may vary. A skilled surgeon therefore can accomplish liposuctionat the different superficial, deep or intermediate layers in anypreferred order or sequence and is not limited to the specific order ofapplication.

Subsequently, postoperative management of the patient as at 36 isaccomplished, as will be set forth in greater detail hereinafter.

In the development and perfection of the VAHDL surgical procedure of thepresent invention, a trial was performed utilizing 306 patients treatedin two separate series. Satisfactory results were obtained in 257patients or 84% of the patients involved in the trial. No cases of skinnacrosis occurred and minor complications included 20 cases of seroma orfluid build-up, nine cases of port site burns and five cases ofprolonged swelling. The conclusions clearly indicated that the VAHDL or“VASER assisted high definition liposculpture” is an aggressive approachto body contouring that enables the surgeon to perform body sculpting ofthe superficial tissues to define the three-dimensional surfacemusculature in a wide range of patients.

Details of the surgical trial included a first step of preoperativemarking performed when the patient is initially in a supine orientationand completed when the patient is an upright, standing position. Duringthe preoperative marking, the physician should recognize that surfaceanatomy varies between men and women wherein the “V” shape is desirablein the male back as is a convexity over the inferior portion of theobliquus muscle. In women, the landmark may include the serratusinterior, the rectus abdominis, the external oblique, the iliac crestand the inguinal ligaments.

In the infiltration procedure 14, as represented in the accompanyingFIGURE, both superficial and deep infiltration were performed using astandard saline solution with the addition of epinephrine in indicatedvolumes as set forth above. Symmetric volumes were infiltrated about thesurgical site and specifically on each side of the body torso. Theinfiltration aspiration ratio was 1.5-2:1. Detailed infiltration wasperformed in areas that required more superficial works such as thewaist and perigluteal area in women, the indentation of the rectus andserratus muscles in men and the areas of skin laxity, such as thehypogastrium. In anticipation of the use of VASER technology, the exactamounts of infiltration in each area and the estimated time of VASER usewere recorded. An estimated 10 minutes was allowed after infiltrationbefore commencement of the VASER emulsification in order to allow timefor effective vasoconstriction.

The emulsification procedure was performed in accordance with the chartof volume infiltrated in the same order as the infiltration. Theduration of VASER treatment was 1 minute per each 100 mL ofinfiltration, but the clinical end point was the loss of resistance.Areas of high de-bulking, such as large fat deposits, were treated,utilizing VASER technology, with 3.7 mm or 2.9 mm, 3-groove probe, at80% power in a continuous mode. The back and posterior arms were treatedusing a 3.7 mm, 1-groove probe in continuous mode. Thin skin or delicateareas such as the inner thighs, waist and neck were treated using a 2.9mm, 3-groove probe at 60% power in a pulsed mode. Differentialemulsification was performed for each muscle group and the muscle lines.Superficial emulsification was performed using a 2.9 mm, 3-groove probe,always in a pulsed mode. In some cases, additional infiltration wasperformed prior to the superficial emulsification. It was noted that thesuperficial emulsification addresses the immediate sub-dermal plane,thereby allowing enhanced skin retraction and compensating for areas ofmuscle or fascial laxity. The emulsification focused on three lamellarlayers. The clinical end point in superficial layer emulsification wasalso the loss of resistance, but the skin was never allowed to becomewarmer than the hands of the surgeon. The achievement of loss ofresistance in this layer without heat generation is a factor in avoidingcomplications.

In the associated de-bulking technique, ventilated cannulas withspecialized small holes which prevent clogging achieved optimalefficiency and provided gentle suction that minimizes trauma. De-bulkingbegan at the areas of fat deposits in the deep layer, using 3.7-mm or4.6-mm cannulas and continued in the mid-lamellar layer and betweenmuscle groups, avoiding aspiration against delicate sub-dermal layers.

Superficial emulsification and extraction steps were performedselectively over the muscular frame in each area to define relevantanatomy for each muscle group (i.e. linea alba and its tendinousinsertions, the pectoral inferior line, inguinal ligament), using a2.9-mm probe emulsification and 3.0-mm cannula aspiration. Superficialemulsification and extraction were performed in the sub dermal lamellarlayer. From an artistic point of view this step is analogous to theinitial two-dimensional sketch of any drawing.

The transitioning technique further comprises the blending of theframing and typography of the muscles. More specifically using a 3.7-mmor 4.6-mm cannula, some of the remaining fat deposits over each of themuscle grouping was de-bulked, while the surface overlying the creasesover the mid-lamellar layer was smoothed, thus improving the definitionof the superficial anatomy landmarks. Transitioning creates the naturalbut well defined appearance that was sought to be achieved. From anartistic point of view, the transitioning step is equivalent to theaddition of “shadows and light” to create a three-dimensional“rendering”. The surgical end point was the definition of the lateralborders of the muscles while retaining a thin layer of fat in the rangeof 1 cm in a pinch test.

In the postoperative management 36 open drains were left for 48-72 hoursin the sacral area in female patients or in the inguinal area in malepatients. Postoperative care included the use of a mild compressiongarment, deep vein thrombosis stockings and a cotton-lamented soft foamband, which may be used for a period of up to four weeks. Patients weregiven oral antibiotic and anti-inflammatory drugs for a short period oftime. After 48 hours, patients were allowed to start postoperativelymphatic drainage massages and adjunctive external ultrasound of onehour sessions, once a day for ten days.

Patients were followed postoperatively at 1, 3, 6, 12 and 24 weeks. Theanatomical definition accomplished at surgery was lost in the earlyinitial postoperative period because of swelling. However, theaccomplished definition started to reemerge at 3-4 weeks postoperative.Patients also experienced indurations during the first 6-8 weekspostoperatively that tended to be migratory, particularly in the areasof definition where contour was created by superficial and transitioningwork. In all cases, these indurations disappeared completely by thethird month. Patients also experienced cyclic swelling that varied theappearance of definition throughout the day. At approximately 4 monthspostoperatively, the swelling abated and patients could see about 95% oftheir final results and accomplished muscular definition.

Since many modifications, variations and changes in detail can be madeto the described preferred embodiment of the invention, it is intendedthat all matters in the foregoing description and shown in theaccompanying drawings be interpreted as illustrative and not in alimiting sense. Thus, the scope of the invention should be determined bythe appended claims and their legal equivalents.

Now that the invention has been described,

What is claimed is:
 1. A surgical procedure for performing liposculptureon the human body, said surgical procedure comprising: marking a portionof at least one limb of the body to define a surgical site, infiltratinga predetermined quantity of solution about the surgical site, performingmulti-layer emulsification of fat deposits at the surgical site,including a superficial layer emulsification, an intermediate layeremulsification and a deep layer emulsification of fat deposits, andextracting emulsified fat deposits from multiple layers at the surgicalsite, including at least a deep layer; a superficial layer and anintermediate layer.
 2. A procedure as recited in claim 1 furtherdefining and marking the surgical site as substantially 360° about theat least one limb of the body.
 3. A procedure as recited in claim 1comprising performing the multi-layer emulsification using VASERtechnology.
 4. A procedure as recited in claim 1 wherein the infiltratedsolution is epinephrine with a saline solution.
 5. A procedure asrecited in claim 1 further comprising forming a plurality of anatomicalincisions over the surgical site and introducing the predeterminedquantity of solution through the plurality of anatomical incisions.
 6. Aprocedure as recited in claim 5 further comprising introducing thepredetermined quantity of solution using infiltration cannulas.
 7. Aprocedure as recited in claim 1 comprising accomplishing a sub-dermalsuperficial release of fat deposits and thereby produce skin retractionby performing the superficial layer emulsification of fat deposits.
 8. Aprocedure as recited in claim 7 comprising creating predeterminedanatomical landmarks by using underlying anatomical structures as aguide for a superficial layer emulsification.
 9. A procedure as recitedin claim 1 comprising extracting the fat deposits which primarily createdeformities about the surgical site by performing liposuction at thedeep layer.
 10. A procedure as recited in claim 9 comprising making theportion of the at least one limb correspond to predetermined anatomicallandmarks of muscle tissue about the surgical site by performingliposuction at the superficial layer.
 11. A procedure as recited inclaim 10 comprising distinguishing differences between surgicallyaffected anatomical sections of the surgical site by performingliposuction at the intermediate layer.
 12. A procedure as recited inclaim 1 further including transitioning superficial anatomy landmarkscomprising extracting at least some remaining fat deposits existing overmuscle groupings associated with the superficial anatomy landmarks andsmoothing the surfaces over the associated superficial anatomylandmarks.